Thursday, January 29, 2009

Last night a standing room only overflow crowd of residents, neighborhood leaders, healthcare advocates and others spoke out in favor of restoring Charity Hospital in New Orleans.

The audience heard the details of a plan to build a world-class, state of the art academic medical center inside the four walls of Charity Hospital for hundreds of millions of dollars less years earlier than LSU's plan to demolish the historic Lower Mid City neighborhood to build an unsustainable $1.2 billion medical center.

The meeting was hosted by the ReBuild Center at St. Joseph's Church and was sponsored by the Committee to ReOpen Charity Hospital, Louisiana ACORN, the United Teachers of New Orleans and C3.

BATON ROUGE -- Members of a legislative budget committee grilled state officials Thursday about the financing for a proposed New Orleans teaching hospital and the decision to ignore potential alternatives that could prove less costly and less disruptive to existing neighborhoods.

It's unclear whether the seven hours of testimony will have any effect on the state's ongoing effort to build a replacement for Charity Hospital, as Gov. Bobby Jindal's administration has given no indication of backing away from its plan to build a $1.2 billion academic medical complex in lower Mid-City.

But the hearing by the House Appropriations Committee provided lawmakers with their most extensive look at a plan offered by the Foundation for Historical Louisiana that calls for gutting the old Charity Hospital building and refurbishing it into a first-rate teaching hospital.

Steve McDaniel, an architect with the New York firm RMJM Hillier, said the state could shave $283 million from its expected costs by doing a gut-rehab. That includes money saved by not having to acquire land, and more than $100 million in savings through federal and state tax credits that would not be available should the state build a new facility.

"The question isn't whether we want state-of-the-art care, but how we get it, " said Sandra Stokes, executive vice president of the historical foundation.

State facilities director Jerry Jones disputed the cost estimates, and said the preservationists' plan could actually prove more expensive than what the state is proposing. He said the gut-rehab plan does not account for the cost of medical equipment, parking, information technology and an ambulatory care building that the state included as part of its figures.

The preservationists found a receptive audience among legislators, some of whom appear to be growing increasingly concerned about the cost and timetable of building a new hospital and the prospect of uprooting existing homes and businesses. The state's plan calls for spending $54 million to buy hundreds of properties inside a 70-acre footprint bordered by Canal Street, South Rocheblave Street, Tulane Avenue and South Claiborne Avenue.

"It just doesn't make much sense to me to tear up this entire neighborhood, " said House Speaker Jim Tucker, R-Algiers. Tucker said the state already owns land along Tulane Avenue, west of Interstate 10, that could be put to a medical use without affecting private property owners.

Bobbi Rogers said she and her husband are among several neighborhood residents who received taxpayer-financed Road Home grants to rebuild properties that were destroyed by Hurricane Katrina, only to face the prospect of having them taken by the state.

"These are the people that make New Orleans work, " Rogers said.

But Pam Perkins, the general counsel for the state Division of Administration, said the vast majority of property owners in the area have indicated a willingness to sell their property. "They are very eager to get on with their lives, " Perkins said.

Tucker joined several legislators in questioning the financial underpinnings of the project.State officials have $450 million committed, and are counting on FEMA recovery dollars and a future bond issue to cover the rest. But there is no guarantee that the federal dollars will be forthcoming, and the shaky credit markets have made it difficult for many large-scale projects to obtain financing.

"I am very leery about getting halfway pregnant in this process and not being able to complete it, " Tucker said.

There is also the matter of the state's constitutional limit on borrowing. The Jindal administration plans to structure the bond issue in a way that the money doesn't count against the cap. But there is no guarantee that the bonds could be issued without a state guarantee, and state Treasurer John Kennedy said taxpayers would likely be on the hook if the hospital can't pay back the bonds.

Dr. Fred Cerise, who oversees health-care services for Louisiana State University, said the state's plans to build adjacent to the new VA hospital would save $400 million over 25 years by allowing the two hospitals to share certain functions."I think we lose critical financial and clinical efficiencies" by not building next to the VA, Cerise said.

Rep. Kevin Pearson, R-Slidell, said the state could solve the proximity problem by building a Disney World-style rail system to shuttle doctors and medical students between the two facilities.

House Speaker Pro Tem Karen Carter Peterson, D-New Orleans, said LSU needs to do a better job of reaching out to Tulane University, Xavier University and other institutions that will be using the new hospital to train medical students and allied health workers.

"There needs to be a different level of engagement and commitment to other stakeholders, " Peterson said, adding that a failure to do so could result in a loss of support for the project from New Orleans legislators.. . . . . . .

Wednesday, January 21, 2009

Hospital at risk

Published January 22, 2009

State government and Louisiana State University are undermining New Orleans' chances for quick progress toward a new medical complex. Whether through misguided planning or stubbornness, they are defending a plan that:

-- Adds hundreds of millions of dollars of unnecessary expense when state and federal resources are shrinking.

-- Imposes a long construction schedule for a new LSU hospital, delaying its completion by two years.

-- Invites controversy and more delays through lawsuits challenging the secrecy and flawed planning procedures.

-- Causes City Hall to waste $79 million to buy land, demolish architecturally valuable houses and relocate residents from a site that wouldn't be needed by a smarter hospital plan.

-- Completely ignores the immense value of one of the nation's best-designed, best-constructed, still usable medical buildings.

Why are they putting at risk the single most important economic development project this region has begun since Katrina? Their plan may fail to get financing because of its illogic and waste. And then where will we be?

LSU and the administration of Gov. Bobby Jindal are commendably right in envisioning a major medical complex and committing to put it in downtown New Orleans. But they are wrong in planning the project largely behind closed doors and ignoring at least one appealing alternative. It's not too late for them to start doing it right.

In 2006, the Legislature gave the Foundation for Historical Louisiana the job of assessing the condition of Charity Hospital, the durable 1939 landmark that has long symbolized Louisiana's commitment to taking care of its people. Lawmakers wanted to make sure, before LSU irrevocably committed to new construction, that Charity -- with its great location and its million square feet of interior space -- was being properly valued.

The foundation raised $600,000 to pay for a study by architects RMJM Hillier, who have deep experience in both hospital design and historic preservation.

Their August 2008 report demonstrated that Charity could be totally gutted and rehabilitated with new systems and state-of-the-art technology to create a new hospital that would work better than new construction, would be finished at least two years sooner and would cost 22 percent less -- $136 million less.

Keeping the LSU hospital in Charity allows the Veterans Administration hospital to move to the currently proposed LSU site -- meaning that the city wouldn't need to spend that $79 million for land and evictions for the VA. That's $215 million in savings -- before counting the benefits of bringing the biomedical district into reality two years sooner.

The state budget, developed in the pre-recession days of surpluses, now faces $2.34 billion of cuts this year and next, much of it in health care.

A rational Gov. Jindal probably will perceive that spending hundreds of millions of dollars unnecessarily just won't work in 2009. And President Obama's stimulus program surely expects higher investment returns than LSU's wasteful plan offers.

The state House Appropriations Committee has scheduled a hearing today on the proposal to rehab Charity. The committee should call for a speedy independent study of the costs and benefits of both plans. The Jindal administration should also insist that LSU be open with the public.

This question is being posed by a coalition of groups who wonder whether the current plans to abandon the Charity and Veterans Administration hospitals are wise or final ones.

Consider the statistics compiled by the Vieux Carre Property Owners, Residents and Associates; the Foundation for Historical Louisiana; and the National Trust for Historic Preservation:

If the ruinous plan goes forward in its current state, more than 70 acres of Mid-City will be demolished and more than 1 million square feet of downtown office buildings will be left abandoned.

Much of downtown New Orleans will be set firmly on the path to blight, and a large area of Mid-City will become parking lots.

--- Do the math ---

State and local officials seem strangely unmoved by the findings of a report requested by the Legislature and paid for by the Foundation for Historic Louisiana.

The study estimates that the 70-year-old Charity Hospital building could be rehabilitated in three years at a cost of $484 million. Building a new hospital would require two extra years and an additional $124 million.

It's the sort of math you'd expect the state to be moved by at a time when Louisiana faces a projected $2 billion deficit in the 2009-10 budget year that starts July 1.

It's the sort of thing in which you'd expect the New Orleans mayor or City Council to take a public interest.

Several relevant hearings were held by federal agencies, in fulfillment of requirements of the National Historic Preservation Act and National Environmental Policy Act.

However, neither the mayor nor the City Council has sponsored hearings on the subject.

--- Years of waiting ---

It's been three years since American soldiers cleaned the first few floors of Charity Hospital and, according to physicians familiar with the work, rendered them safe for patients.

It's been more than three years that we have been without the city's most important health care facility.

And, if this plan goes forward, it'll be five years before a replacement facility is ready for us.

In the meantime, New Orleanians should be certain not to get sick.. . . . . . .

Tuesday, January 20, 2009

For the past couple of weeks LJI Co-Director Jacques Morial has been working with Merger Watch (www.mergerwatch.org) and the ACLU of Louisiana to examine the proposed alliance between LSU and Our Lady of the Lake Regional Medical Center (OLOL) in Baton Rouge. As you may know, LSU recently announced that it is cancelling the long -studied plans to build a replacement facility for Earl K. Long Medical Center in Baton Rouge due to funding constraints. Instead, LSU has decided to pursue an alliance with the Franciscan owned and operated OLOL Hospital, where EKL patients would be treated at OLOL Hospital and where residents and other medical professionals would train.

This proposed alliance concerns us for several reasons, including:1. Access to healthcare services in the North - Central Metro BR area would be severely curtailed.2. Access to services and information related to reproductive health would likely be restricted at this private, catholic OLOL Hospital and facility.3. Graduate Medical Education would likely not include critical training in reproductive health, including birth control and women's health, and sexually transmitted diseases.4. The proposed alliance could give raise anti-trust concerns because of OLOL's already commanding market share of acute care hospital services in the Metro Baton Rouge Market.

Furthermore, there is a legal conflict: the Taylor and Porter law firm – attorneys for LSU – also represent OLOL. Taylor and Porter recently asked the State Ethics Commission for an advisory opinion on this matter. The Ethics commission was non-committal. What is telling is that the Taylor and Porter firm did not request an opinion from the one legal body responsible for governing ethical transgressions by Louisiana licensed attorneys, the Office of the Chief Disciplinary Counsel. That would be Charles B. Plattsmier. Some call him Voldemort. No doubt, this fool-hearty move by the Firm will hit Mr. Plattsmier’s desk very soon. This issue is just more evidence of LSU's arrogant attitude related to healthcare access.

The fact that Taylor and Porter is representing both parties in this matter is outrageous. Even more disturbing is that we've seen no evidence of how this proposed alliance will improve access to vital healthcare services for the most vulnerable populations in the Baton Rouge area.

I expected I would have had a pretty relaxing weekend. We are celebrating history in this nation, inaugurating Barack Obama as President of the United States of America. Rev. Dr. Martin Luther King, Jr. commemorations are in full swing. And republican and democratic politicians appear to understand (maybe its temporary), that we are one nation, united.

Then I read my January 18th Times-Picayune, and learned the City of New Orleans Office of Inspector General has requested additional funding to arm its staff of twenty with “standard issue” law-and-order hardware, including semiautomatic pistols, miniature rifles, ammunition, laser sighting devices, bulletproof vests, handcuffs and leg irons. IG Robert Cerasoli was hired to identify and investigate inefficiencies in government and “weed out” possible white-collar corruption. So far – after over a year on the job – Mr. Cerasoli has issued one interim report on ‘take-home’ cars. Take-home cars.

There are plenty of arguments I could make about why this is a bone-headed idea. First, these folks don’t have arrest powers. I just loved the statement by Leonard Odom, Cerasoli’s first assistant, who indicated OIG needs handcuffs and leg restraints ‘until the police arrive.’ News flash: if you don’t have a valid warrant signed by a judge, that’s called false arrest and imprisonment.

And then there’s the whole ‘overlapping authority’ thing. Cerasoli took this job understanding he would be working side-by-side with real law enforcement agencies – NOPD, Orleans Parish Criminal Sheriff’s Office, Louisiana State Police, and FBI. “Pish-posh” I guess according to Cerasoli. Those other law enforcement folks are amateurs compared to his newly hired, crack-staff, of mileage hounds! Cerasoli’s OI-GMen are in-the-house, ridding City Hall of paper-wasters, pen thieves, and email spammers.

Yes, I was outraged. Cerasoli, you were hired to investigate corruption in government. That means investigate, get a subpoena if you believe a crime has been committed, forward your findings to the appropriate authorities – NOPD or OPCS or Louisiana State Police or FBI – and move on. Why in the world do you think you need leg-irons and machine guns to investigate white collar crime? This is an unwarranted, unnecessary, and illegal usurping of power at taxpayer expense.

It’s ‘Cerasoli Gone Wild’ showing his soft, unattractive underbelly.

Even if you hate Mayor Nagin – I’ve called him a knucklehead more often than most – if you’re sane, you’ve got to be hoping Ray instructs NOPD Superintendent Riley to refuse any request to deputize and arm OIG employees.

Regardless of what Nagin says, however, the hard truth of the matter is that Cerasoli can spend OIG budgeted funds and arm all 20 of his employees – the secretaries, the runners, the lawyers, the accountants – everybody. But none of us should countenance any civil servants’ attempt to arrest and detain anyone without proper legal authority.

This is New Orleans, not the Wild-Wild West. Annie and Robert – Drop the Gun!

Thursday, January 8, 2009

This news report and the accompanying article come from wwltv.com. Watch their report here.

Dennis Woltering / Eyewitness NewsJanuary 7, 2009FEMA says it won't pay more than $150 million dollars for Katrina's damage to big charity, but the state argues it deserves full replacement cost -- $492-million dollars because Katrina caused more than 50 percent damage.

One month ago, legislators trying to decide if charity should be gutted and renovated or if a new hospital should be built held a public meeting to tour the place, but the news media were kept out of that public meeting.

Finally Wednesday, after reporters signed liability waivers state officials required because of what they described as dangerous conditions, we were allowed to see the inside of Big Charity.In the first media tour since January 2005, we got a chance to see the Psychiatric Unit on the 3rd floor, laboratories on the 11th floor and surgical suites on the 12th floor, among other areas.

One the areas legislators saw here on the 12th floor in December the paint was peeling on many of the walls, and in some of the operating suites there were lots of clutter and bags of trash.

Throughout the tour, we saw lots of debris, ceilings that are broken apart, rooms piled with furniture, equipment and boxes. Everywhere, doors were off their hinges, an effort to help ventilation, according to our tour leader, Mark Moses of state Facilities Planning.

“By taking the doors off the hinges we're able to get air throughout the building,” he said.The stairs were used because officials say they had an electrical problem about two weeks ago they are still trying to fix.

“Entergy took us off-line because they determined that the switch gear was no longer safe for them to connect,” said Robert Arnold, facility director, adding there is water in the basement because without electricity they can't run the sump pumps necessary to keep it dry.Water was in other places due to pipe leaks.

“For a hospital that’s been abandoned for three years, I would expect to see this,” said Dr. James Moises.

Moises, who was once an emergency physician at Charity, questions why the hospital place can't be renovated.

“I mean these pictures tell it all. This is not a building that is 50 percent damaged,” he said.Pictures taken at the end of September of 2005 after Moises, some military people and others cleaned the first few floors of the hospital show the condition is worse now.

“And it was not cluttered and dirty like it is now,” he said. “So clearly, either by neglect or intentional neglect, the building is in worse condition now that it was in September of 2005.”

State officials said mold and asbestos make Charity dangerous, but they didn't feel a need to wear breathing masks, which they offered to us. Dr. Moises argues it is not dangerous, just a campaign to get federal money for a new hospital.

“Sure this is clutter. It's like anybody's garage or home that is cluttered,” he said.

Is Big charity structurally sound? Could it be renovated into a state-of-the-art hospital faster and less expensively than a new hospital as critics like Moises believe? Those are questions Governor Jindal and the legislature have to decide.